Efficacy of extracorporal shock-wave treatment for calcific tendinitis of the shoulder: experimental and clinical results

Perlick, L.; Lüring, C.; Bäthis, H.; Perlick, Carsten; Kraft, C. N.; Diedrich, O.

doi:10.1007/s00776-003-0720-0

Cited by 52 publications

(53 citation statements)

References 12 publications

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“…The most convincing data are seen in the treatment of calcific tendonitis of the supraspinatus. Several large randomized, controlled trials report good results using ESWT in the treatment of calcific tendonitis of the rotator cuff with a reported improvement in pain scores and a decrease in the size of calcific deposits seen on radiographs compared with placebo [4,31,39,59,98,110,123,130,131,136,140]. One advantage to treating calcific tendonitis with this method is the ability to visualize the area of pathology and target this area with the shock waves [67,74,150].…”

Section: Extracorporeal Shock Wave Therapymentioning

confidence: 99%

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Andres

Murrell

2008

Clinical Orthopaedics &Amp; Related Research

442

345

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Tendinopathy is a broad term encompassing painful conditions occurring in and around tendons in response to overuse. Recent basic science research suggests little or no inflammation is present in these conditions. Thus, traditional treatment modalities aimed at controlling inflammation such as corticosteroid injections and nonsteroidal antiinflammatory medications (NSAIDS) may not be the most effective options. We performed a systematic review of the literature to determine the best treatment options for tendinopathy. We evaluated the effectiveness of NSAIDS, corticosteroid injections, exercise-based physical therapy, physical therapy modalities, shock wave therapy, sclerotherapy, nitric oxide patches, surgery, growth factors, and stem cell treatment. NSAIDS and corticosteroids appear to provide pain relief in the short term, but their effectiveness in the long term has not been demonstrated. We identified inconsistent results with shock wave therapy and physical therapy modalities such as ultrasound, iontophoresis and low-level laser therapy. Current data support the use of eccentric strengthening protocols, sclerotherapy, and nitric oxide patches, but larger, multicenter trials are needed to confirm the early results with these treatments. Preliminary work with growth factors and stem cells is promising, but further study is required in these fields. Surgery remains the last option due to the morbidity and inconsistent outcomes. The ideal treatment for tendinopathy remains unclear.

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Section: Extracorporeal Shock Wave Therapymentioning

confidence: 99%

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Andres

Murrell

2008

Clinical Orthopaedics &Amp; Related Research

442

345

View full text Add to dashboard Cite

show abstract

“…Frequently, initial treatment modalities for the disease are aimed primarily at symptoms, focusing on adequate analgesia with nonsteroidal antiinflammatory drugs (NSAIDs) or local infiltration of crystalline steroidal suspensions, biding time until the symptoms are alleviated. When conservative therapy has not been effective in relieving pain and other symptoms, extracorporeal shock-wave therapy (ESWT) has been used, yielding results such as relief of pain and improved function (2,31 (34). Only in resistant cases are further, more invasive steps considered, with surgery being the ultimate step (31).…”

Section: Discussionmentioning

confidence: 99%

“…When conservative therapy has not been effective in relieving pain and other symptoms, extracorporeal shock-wave therapy (ESWT) has been used, yielding results such as relief of pain and improved function (2,31 (34). Only in resistant cases are further, more invasive steps considered, with surgery being the ultimate step (31).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of Rehabilitative Management with Extracorporeal Shockwave Therapy in Rotator Cuff Disease with Partial Tears

et al. 2012

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The purpose ofthis study is to evaluate the effects of rehabilitative approach using MJS and dynamic antigravity postural system (SPAD) with extracorporeal shockwave therapy (ESWT) on rotator cuff syndrome associated tendon supraspinatus and infraspinatus medium tear (1-3 em) of the tendons. In the last few years, ESWT has been proposed as an elective treatment in somatic diseases with encouraging short-term results. For this study the authors enrolled 108 patients who underwent 3 treatments with ESWT associated with 24 rehabilitation sessions over 3 weeks. Outcome measures were the VAS for pain and the Constant Murley Scale. The outcomes were measured pre-training, post-training and at 2, 4, 6 month follow-ups. Additional follow-up evaluation sessions were performed every year for 5 years by a telephone interview to evaluate changes in pain and function and the efficacy of treatment. Our study shows that the therapeutic efficacy of rehabilitative approach with ESWT in the rotator cuff syndrome with medium tears persists over time and significantly improves the patient's quality of life. The results obtained are certainly to be attributed to the biological mechanisms that ESWT are able to engage in tissues of the rotator cuff. The results seen at the conclusion of the treatment were maintained over the following years, thanks to the use of MJS and SPAD. In our opinion a conservative treatment with extracorporeal shock-wave (ESW), dynamic antigravity postural system (SPAD) and multi joint system (MJS) should be considered as an alternative and effective treatment for rotator cuff syndromes with medium tears.Clinical use of shock waves was first applied in therapy for renal stones, where it was casually noted to have an effect on the iliac bone with primary osteocyte damage, followed by osteoblastic stimulation (1). Consequently, extracorporeal shock wave therapy (ESWT) was introduced for the treatment of the nonunion of bones with positive results documented by several papers (2).At present, shock wave therapy is widely applied in the treatment of musculoskeletal disorders, such as the nonunion of long bone fractures, calcifying tendonitis of the shoulder, lateral epicondylitis of the elbow and proximal plantar fasciitis; in addition, the success rate of the application ranges from 65% to 91% (3).Shock waves could promote growth and

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“…[53] Perlick ve arkadaşları ise, etki mekanizmasının kalsifikasyonun fiziksel parçalanma ve erimesine değil, şok dalgalarının dokuda yarattığı mekanik irritasyon sonucunda inflamatuvar değişikliklerin tetiklenmesine bağlı olduğunu düşünmektedirler. [54] Wang ve arkadaşları da, kalsifikasyondaki çözülmenin mekanik irritasyona yıllık takipte cerrahinin (%90 başarılı) ESWT'ye (%64 başarılı) oranla daha başarılı olduğunu tespit etmişler-dir. Homojen ve keskin sınırlı kalsifikasyonu olanlarda (Gartner Tip I) cerrahi daha iyi sonuçlara varırken, Gartner Tip II kalsifikasyonu olanlarda (keskin sınırlı, homojen olmayan kalsifikasyon ya da sınırları belli olmayan homojen kalsifikasyon) iki tedavi şekli arasında fark bulunamamıştır.…”

Section: Omuzun Kalsi̇fi̇ye Tendi̇ni̇ti̇nde şOk Dalga Tedavi̇si̇unclassified

“…[63] Benzer şekilde, Perlick ve arkadaşları, yüksek enerjili (0,42 mJ/mm 2 ) şok dalga tedavisinin orta enerjili (0,23 mJ/mm 2 ) tedaviye göre kalsifikasyonların çözülmesi anlamında daha başarılı olduğunu, iki grupta da fonksiyonel ve ağrı skorlarında belirgin düzelme görülmesine rağmen, gruplar arasın-daki farkın istatistiksel olarak önemli olmadığını bildirmişlerdir. [54] ESWT'nin kalsifiye tendinit tedavisinde bildirilen olumlu sonuçlara karşılık, Charrin ve Noel, 0,32 mJ/ mm 2 enerji kullanarak tedavi ettikleri hastalarda, 12 haftada %36,6 ve 24 haftada %55,1 subjektif düzelme elde etmişler ve radyolojik olarak kalsifikasyonda kaybolma sadece %17,7 olguda tespit edebilmişlerdir. [56] ESWT uygulamasında şok dalgalarının kalsifikasyonun merkezine odaklanması önemlidir ve klinik sonuç-ları olumlu etkiler.…”

Section: Lateral Epi̇kondi̇li̇t Tedavi̇si̇nde şOk Dalga Uygulamalariunclassified

Ortopedi ve travmatolojide şok dalga tedavisi

Lok¹,

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Baloğlu³

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Efficacy of extracorporal shock-wave treatment for calcific tendinitis of the shoulder: experimental and clinical results

Cited by 52 publications

References 12 publications

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

Long-Term Results of Rehabilitative Management with Extracorporeal Shockwave Therapy in Rotator Cuff Disease with Partial Tears

Ortopedi ve travmatolojide şok dalga tedavisi

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